pylori eradication rather than just

focusing on chronic gastric lesions. Future indications for H. pylori eradication should focus more on reversible lesions before preneoplastic conditions develop. One could take the view that everyone with Helicobacter pylori infection would be better off without the bacterium. However, in countries with a higher prevalence of H. pylori infection, it is not possible to achieve this goal because of its low cost-effectiveness. For this reason, selleck kinase inhibitor current indications for H. pylori eradication vary among countries (Table 1).1–6 Peptic ulcer, mucosa-associated lymphoid tissue (MALT) lymphoma, early gastric cancer, iron-deficiency anemia, idiopathic thrombocytopenic purpura, chronic atrophic gastritis, and functional dyspepsia are the common indications. Some guidelines also include consideration of the patient’s wishes, communities with a high incidence of gastric cancer, family history of gastric cancer, long-term use of non-steroidal anti-inflammatory drugs (NSAIDs)/aspirin

or proton pump inhibitor (PPI) therapy, or gastroesophageal reflux disease. Notably, lymphocytic gastritis and Ménétrier’s disease learn more are indications for H. pylori eradication in China, whereas gastric hyperplastic polyps less than 1 cm in size and chronic urticaria are indications in Japan. In Asia, high reinfection rates in the community make H. pylori cure a temporary event, and this also has resulted in there being fewer indications for H. pylori eradication in Asian countries than in Western guidelines. The latter also show wider indications, with an emphasis on the potential of H. pylori eradication for the prevention of gastric cancer. The prevalence of H. pylori infection is currently declining rapidly in Asia, and thus the indications for treatment should be expanded. Given that H. pylori eradication is

effective when the lesions it causes are reversible, current indications should be expanded to include acute gastric lesions that show marked improvement upon H. pylori eradication rather than uniquely focusing on chronic gastric lesions. The aim of this review is to identify future candidates for H. pylori eradication, that is indications that are not currently included HAS1 in the guidelines or, in some cases, may not yet have even been discussed. The aspects that will be covered, based on emerging evidence, include acute gastritis, chronic gastritis, the patient’s wishes, and extraintestinal diseases. Acute gastritis related to recent H. pylori infection includes nodular gastritis, follicular gastritis, lymphocytic gastritis, hemorrhagic gastritis, granulomatous gastritis, hypertrophic gastritis, Ménétrier’s disease, and congestive gastropathy; these conditions are more reversible than chronic gasritis.7 They are therefore assigned as supportive indications for H.